Boney has achieved “grumpy old man” status.
Boney is a little terrier-type dog who is rapidly approaching his 16th birthday. Like many 16-year-old dogs, he suffers from a few ailments. Gratefully, all of them allow him to continue to function.
Boney has arthritis. In addition, he has a liver malfunction. We don’t know the exact nature of his liver problem because to determine that would require a liver biopsy. At this point we can’t justify a biopsy of Boney’s liver because:
- we are able to manage his liver problem medically
- as long as we can manage the disease, it isn’t life-threatening
- a liver biopsy is a surgical procedure under general anesthesia, which we would rather avoid at Boney’s age
- given that Boney’s liver disease is relatively low-grade, curing it, even if we could, would not significantly increase his longevity
The rub comes in when we consider that the Non-Steroidal AntiInflammatory Drugs (NSAIDs) that we typically use for canine arthritis can sometimes cause, as well as exacerbate liver-related illness. Therefore, all patients need to have laboratory testing prior to beginning an NSAID so that we know what the status of the liver is prior to beginning the medication. The Chemistry Profile is used to determine that.
On Boney’s pretreatment Chemistry Profile we determined that there was a preexisting liver problem. To address that, we began a daily regimen of Denosyl. Denosyl is in the SAM-e family of neutraceuticals. Neutraceuticals are nutrients that have pharmaceutical properties. While neutraceuticals are not regulated by the FDA, as pharmaceuticals are, the NutraMax Laboratories company voluntarily submits samples of Denosyl, Cosequin and Dasuquin to an independent laboratory for analysis to confirm that the product, does, in fact, contain what it says it does and is free of contaminants.
Denosyl will give Boney’s liver protection and help it to work better. As a result, he can take an NSAID even in the face of liver problems. To know whether his liver was tolerating the NSAID we retested the Chemistry Profile two weeks after starting the combination. The results, while not normal, were within tolerable limits. We will retest again in two months, then, if results are acceptable, every six months.
We chose Rimadyl as Boney’s NSAID because of its long history of safety and effectiveness. Notice that in Boney’s case we began the Rimadyl and Denosyl simultaneously. Usually we would not do that, preferring instead to give the Denosyl a month to work, followed by a repeat Chemistry Profile, then start Rimadyl after confirming that the liver numbers improved. Boney was simply too painful to wait, so we gave his owner strict instructions to watch for icterus (jaundice) and loss of appetite and report those to us immediately, should they occur. Fortunately, neither sign appeared.
Rimadyl gives Boney relief from inflammation (pain, swelling, heat, loss of function), but to achieve the best possible result he needs something for healing, too. Again we turn to a neutraceutical, Dasuquin, also manufactured by NutraMax. Dasuquin, with its laboratory-confirmed quantity and quality of glucosamine, chondroitin and other ingredients, will help Boney’s joint cartilage to heal by making it smoother and better-lubricated.
At his one-month Medical Progress Examination Boney was already feeling like a new man. Still a grumpy old man, but a pain-free grumpy old man.
See you tomorrow, Dr. Randolph.